April 3, 2006 -- Women approaching menopause are at increased risk for depression, and two new studies offer some of the strongest evidence yet that hormonal changes may be at least partially to blame.

Both studies followed women through the transition to menopause, known as perimenopause. None of the women had a history of depression prior to this time in their lives, but their risk of developing symptoms of depression greatly increased during these years.

The two studies are published in the April issue of the journal Archives of General Psychiatry.

The findings argue in favor of aggressive treatment of both menopausal symptoms and depression symptoms occurring during the transition to menopause, researchers say.

"There is a tendency to dismiss symptoms of depression as part and parcel of this transition, but they shouldn't be discounted," Massachusetts General Hospital researcher Lee S. Cohen, MD, tells WebMD.

"From a public health point of view, depression is a substantial illness with significant morbidity for patients and their families. This is a real problem, but the good news is that it is a problem that can be managed."

Risk of Depression

Cohen and colleagues followed 460 Boston women between the ages of 36 and 45 for up to six years. All of the women were premenopausal at enrollment, meaning that they still had regular periods or had not undergone other changes indicative of transition to menopause.

None of the 460 women had ever been diagnosed with major depression. But those who entered perimenopause during the study period were almost twice as likely as those who didn't to develop significant symptoms of depression.

The risk was greater in perimenopausal women who also had hot flashes, but it was still greatly elevated in those who did not have this and other common symptoms associated with transitioning to menopause, Cohen says.

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As You Journey through Menopause, Vivelle-Dot Is By Your Side

VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.

INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information for Vivelle-Dot.

Prescribing Information